Pouch Selection- 1 or 2 piece? Prior to the 1980s, the only choice that people with ostomies had was to use a 1 piece pouch. This was the standard. Convatec introduced us to the concept of a 2 piece system in the 1980s and now most pouch manufacturers have both a 1 and 2 piece pouching system. Most features(convexity, extended wear barriers, cut to fit, pre-cut, belt tabs, closed-end, drainable, urinary etc) are available in a 1 or 2 piece system. The major advantage of a 2 piece system is that the pouch can be removed or changed without disturbing the flange or seal to the skin surface. This allows for the pouch to be cleansed and air dried for later use if desired, while another pouch is snapped on. The flange is changed usually every 3-5 days. It is also beneficial to use a 2 piece system if routine irrigations(colostomies) are done. The disadvantages of a 2 piece system include that the profile(thickness) of the pouching system is usually more pronounced and may be more visible under tight clothing. 2 piece systems also increase the risk of leakage since there are now 2 points that leakage could occur-1) At the skin and barrier seal and 2) At the point where the pouch and flange snap together. If there are issues with weakness or pain in the hands and fingers, snapping the 2 pieces together may be difficult. There is also the issue that 2 products must be ordered, stored and kept up with. The 1 piece system is simple, usually low profile(less visible under tight clothing) and easier to carry around while traveling, etc. However, if a pouch change is desired, then the entire pouch has to be removed from the skin and a whole new system applied. The decision is up to the person with the ostomy…in most cases. Looking through the many websites of the pouching manufactures may help with this decision. It is also desirable to try both 1 and 2 piece systems to determine which meets the needs of the ostomate. All manufacturers will provide samples for trial.